In finalising this brief three-part series of self-reflective articles on ‘me’ and my relationship with trauma or specifically CPTSD you may have guessed from Part 1 and Part 2 that ‘Jack in the Box’ was not ‘something’ that suddenly jumped out at me. Jack had always been there since the age of 22 months old and the first traumatic event I became aware of but I had no memory of it. One might even argue there had been intergenerational trauma transferred on, the violence perpetrated by my grandfather and my great grandfather.

As I was informed my mum was a product of her father and he was a product of his. The theme of ‘violence’ was common. Who knows what influence social environmental factors and DNA / genetics played in any predisposition to such traumatic events for me in those first thousand (or 1460 days) age 0 to 4 (1971-1975). Intergenerational trauma affects individuals, communities and cultures, it does not discriminate and it is not exclusive. Regardless ‘Jack’ had indeed been there waiting and then when the predicted moment’s arrived the seeping, oozing and spilling out of varying levels of pain, anguish and trauma led me and my brain down an unknown terrifying path which left me wondering ‘how did this happen?’ and ‘why was I repeating some of this stuff?’.

There was no help, education, direction as a child and adulthood change was slow. Blame, shame, guilt, and periods of remorse and hurt were the reality. I was on my own working this out in my early adult years.

As my childhood played itself out I can point to certain adversity’s in this time period and also link behaviours/emotions to differing forms of trauma be it as a child or adult. The Adverse Childhood Experience Study (1994) now depicts ten adverse factors, originally this was seven. This important study and scale questionnaire act as a useful estimation of the impact of trauma and adversity has had upon a child but also where resilience can enact its part in helping one ‘bounce back’, protect and deal with further adversity in a different, healthier manner the next time. I have commented on the questionnaire scale aspect of this study previously in the ‘Jack in the Box’ series. The reasoning for the ten specified adversity areas on the left of the chart and other types of adversity/trauma missing is explained within the following link https://acestoohigh.com/got-your-ace-score/. What I can say briefly from the chart is that I scored 4 or more. The weblink also details the potential meaning behind a scoring outcome.

In terms of differing and contributing forms of trauma, I have grown up with ‘Complex Relational Trauma’ (close relationships, imbalance of power) and ‘Vicarious Trauma’ (also known as Compassion Fatigue, Secondary Trauma) that have influenced the accumulation of trauma over time. Major Depression and CPTSD’s close alley Borderline Personality Disorder have since been diagnosed. This became a complicated mix and very toxic. Since Part 2, I have built my knowledge not just about resilience which I referred to in Part 1 and 2 but also Post-Traumatic or Psychological Growth. Although there is much debate on the differences it would appear that we attain resilience first followed by Post-Traumatic Growth. I do tend to agree with that argument and processing if the former can be established.

‘Surviving’ and ‘Warrior-like’ are keywords. I never saw myself as one until after the ‘hurricane’ hit in 2017. I was truly blown away and smashed up. Childhood trauma’s met and clashed with adulthood trauma’s (be it all connected). I had overcome them all historically be it unwelcomed, painful, damaging and often repeats of behaviours experienced before. The accumulative trauma over many years with a final 12 round Rocky Balboa boxing match took its toll on the body and mind. I got up…and up…and up, but then one final knockout blow meant I was not getting up in the ten-second count that followed. Only a warrior or survivor could have got as far as I did. In a strange way, I am proud of that. There are many warriors out there.

Readers of ‘Jack in the Box’ Part one and Part two may also have questioned the use of PTSD and that it was something more in line with one its relations. Those people would have been correct. The diagnosis of Complex-PTSD, was a relief as was Cluster B symptoms relating to Borderline Personality. It formed critical information on such mental health condition’s which gave an explanation as well as helped me understand and learn from. The sleep concerns also fitted into that influential learning. ‘Joining up the dots’ as I call it has taken over two years thus far to patch a fragmented story together. It remains limited from the early years due to no memory but I am building a ‘memory palace’ to help me fathom it out and form a picture. Implicit memory 0-3 years approx. and explicit memory from age 3 years onwards makes total sense as well. The trauma/adversity at age 4 years old I can vaguely recollect. At 22 months old nothing. Both implicit memory and dissociation played their parts. There are still people and written records from 1973 that remain with answers. The recent hurricane is gone (although its a memory that will stick) and was significantly central as a trigger which shook my world. It was the final straw ‘the straw that broke the camels back’. I was wounded like never before.

Ill health, challenging therapeutic interventions, a complex medication regime, history digging, and soul searching far more than any previous fall is how it progressed and still does. The presence of the constant rainbow and a specialist care team has slowly moved me forward. C-PTSD is something you have to ‘manage’ the symptoms of, it’s a life long journey. Saying I am ‘not my old self yet’ is simply not possible. With accumulative trauma, you are constantly battling, evolving, learning and changing. Decisions and actions you once took and repeated over time you learn eventually to do something else less harmful. The danger is always lurking – risk-taking thresholds are high, flashbacks occur, you dissociate, memory can be poor, and you feel fatigued and often exhausted. When learning occurs and a new behaviour has been put in place (something DBT helps with) the theory is the brain reorganizes this in line with the significant insight, actions and change – a fraction of the brain, therefore, can be re-wired. You can also grow as depicted in theories relating to resilience and post-traumatic growth, however, it is a long challenging road, not all recover, not all make it. There are no guarantees. One day at a time. We all move at our own paces. Setbacks are frequent. What you once did without thinking and did well you can no longer at that pace, accuracy and influence. In fact, some familiar things scare the hell out of you. Loss and grief are part of this condition and with that lays anger. Isolation is also common and being alone, reading, listening to music, staring out to sea by oneself is for you a way of regaining balance and calmness. People often struggle to understand this.

In Part 2 of Jack in the Box I discussed the nightmares as a child and the transference of trauma onto an animal, a wolf in my instance. These were frightening and were a secret for years. I carried on the secrecy as that seemed to be the trend in my family – secrets were better for children. Knowing and talking about events/incidents was harmful. A well-established myth now. Openness and transparency are key. I can safely say this as a bitter truth as one still working things out from the 1970s. The ‘inner child’ hurt, sad, angry, alone and lost. Talking and meeting that inner child as an adult is important. The child needs to heal and be heard and understood. The child wants answers…why did these things happen to him? Why was the pain there for so long? Why did no one help or listen? Meeting that child and saying this is how I am going to ‘protect’ or keep you ‘safe’ is what they want to hear.

I have made peace with the wolf from my nightmares for it was not the wolf that brought me trauma and pain it was humans and organisations. The lone wolf for me is symbolic of violence (be it seen or the victim), fear, shyness, insecurities, pent up emotions and unable to express what I want to say or not understanding what was going on. Also pushing back towards people but being overpowered. Facing a challenge in life, excluded, afraid to speak up in case of a scary reaction, but also capable of surviving terrible conditions. I was 22 months old. So much on little shoulders and it did not stop there…

In drawing to a close Part 3 I entitled it ‘an ongoing conclusion’ as that is pretty much what it is, why? I still don’t know many things due to dissociation, no memory of certain events when very young and limited information. Time will tell if I get to know of events between 1973 and 1975. Accessing memories? Is that possible when something occurred at age 22 months? Is it worth it? Maybe all we can form is a picture from the information sources we can access still to get anything close to what happened and to look back at the accumulative traumas. That is where many answers lay in our behaviours – attachment disorder being one which appears in relationships.

Managing the symptoms and healing are of key importance and as previously noted not everyone is a size 7 shoe. Pragmatism and Eclecticism are key in my opinion. What works for one might have no impact on another. EMDR and DBT are two interventions well known and highly thought of as well as CBT and Psychotherapy. The reality is that there many choices and are subsequently becoming more varied. A combination of care is key. This might include therapy as detailed, Somatic therapy, mindfulness, meditation, yoga, art and music therapy, pharmaceutical and hallucinogen treatments along with a healthy nutritional diet and daily exercise. Reaching a point of some level of stability is a marathon, not a sprint. If rushed one only gets disappointed. Failure thrives in C-PTSD if you allow it. It’s unbearable. Yes, I do cancel plans and let people down but now I try to do things differently as you never know how you will be from one day to another. One needs to know their risk levels and limitations. Once you may have been like a ‘robot’ but now you’re a million miles away from that level of ability.

On a finishing note before some possible helpful points ‘Jack in the Box’ is now what I would call ‘a state of mind’, trauma fueled – resembles anger when sprung by the amygdala. It has however coached or guided me, alerted me, woke me up, scared me, grabbed me by the scruff of the neck, hung me over a cliff dangling, cut off my sleep, but all with the intention of helping me not to repeat past mistakes and to learn and heal. My job was to listen, overserve all that was going on inside of me, on the outside of me, choices I made and actions I took with whom and why. The ‘wolf’ meanwhile was nothing more than some horrendous powerful emotions which paralysed me in my sleep (REM Sleep Disorder) only to return years later in a different form (Non-Rem Sleep Disorder). The brain works in mysterious ways and it remembers just like the body does. Trauma remains in different parts of the body and reveals itself in various mannerisms. Violent coughs that stopped and started during prolonged periods of stress not realising this its a trauma reaction from the neck/chest area when many years before I had been severely injured there as a 22-month-old. No consultants could ever work out what was wrong. I know now. The same applies to the development of severe obstructive sleep apnea. Cortisol and Seratonin play their part physiological with sugar cravings and weight gain occurring at a rate never known before in my life. Pain in joints and muscles have also been a common feature of the trauma. The body tells us something is vitally wrong. We can listen and ignore but ultimately you only run into a hurricane and that makes you stop and look around.

I now even have a large tattoo of a jet black wolf on my chest. A truce, peace treaty, has taken place and we are all on one side. The aim to be well, and live life again regardless of how long it takes and what setbacks will consume us. Living with CPTSD is sometimes strangely like ‘Jack’ all coiled up and wanting to shoot off emotions when they arise as they are so powerful and negative. The key is to manage those feelings appropriately (learn strategies – like from DBT) and keep that lid on!

Helpful Points:

1. It’s a marathon, not a sprint to move forwards
2. Don’t be ashamed or embarrassed about your mental health issues
3. Seek mental health support – specialist – GP, Clinical Psychologist, Sleep Specialist, Psychiatrist
4. Get a second opinion if you think you have been misdiagnosed – it happens
5. PTSD and C-PTSD is not just a diagnosis for war veterans. That is a myth.6. Research any prescribed drugs a psychiatrist may prescribe you so you are aware of their benefits and effects.
7. Learning to be ‘present’ in your mind as much as possible is a useful tool to learn (Mindfulness). You will be surprised how hard it is with C-PTSD.
8. Have a partner or Sleep App to monitor your sleep patterns. A sleeping trial might be needed – keep a diary.
9. Routine and structure in your day can help but don’t push yourself beyond limitations. It’s ok not to achieve all that is on your list.
10. Exercise and eat healthy (nutritional foods)
11. C-PTSD is about learning your limits (especially in risk-taking behaviours) and managing your symptoms. Reactions in C-PTSD pass straight through to the Amygdala where fight, flight and freeze can occur in response to what you perceive as a threat. The rational brain is hijacked.
12. Carry out the ACE Questionnaire Scale – what is your score? ‘What happened to you’ ask.
13. As a Parent seek help as early as possible if your child has suffered any kind of traumatic event and there is an impact such enuresis, behavioural, nightmares, dip at school etc. Early Intervention is key.
14. Memories and Information from a traumatic event should be collated and stored be it pictures, photographs, letters, written information etc and made available for young children who dissociate or are too young to recall the trauma (A Trauma Log or Trauma Memory Box). An accurate and truthful narrative is required for the developing child so they can process it healthier.
15. Pragmatism and Eclectrism are key foundations for supporting your recovery and moving forwards. Tip: Activities/Hobbies you did in your childhood that you enjoyed beginning again. A combined package of interventions is helpful.
16. You don’t just ‘get over it’ and you will not ‘be your old self’ again.
17. As a practitioner or parent look for opportunities to build resilience in the child early i.e. through strength or the ability the child has as well as increasing social capital and community connectedness. This can lead to Post Traumatic Growth.
18. Isolation at times can be what you need. Don’t be afraid of taking that time.
19. Surrounding yourself with loving, caring and understanding people is so important
20. Rid yourself of toxic people/friends.
21. Plan to attend events no more than 24 hours before. Even then your mood can change but cancel and let people know. You don’t owe an explanation. You will tell people when you are ready.
22. Be realistic, you may never go back to the same job and field of work if that is too stressful.
23. Your body tells you things, speaks to you when things are not right and you are in a situation where trauma is ready to bounce. A bad cough, aching joints, nausea, headaches, migraines, poor sleep, fatigue, poor memory, low mood, lack of motivation, drained, burnt out, days off increase due to unwellness (not usual for you) weight gain (craving sugar/cortisol increase – becomes an escapable problem unless the stress is released). You are a time bomb waiting to go off.
24. Your body remembers the trauma/s. Going back to 22 months old I now know I had food issues throughout my childhood and adulthood due to being force-fed and shouted at by nurses in a hospital. When ‘unpleasant’ moments happened in the hospital my experiences of the same gender group led to later trauma’s when similar unwelcomed behaviours were displayed towards me. The sweats (something bad is going to happen again), blood being directed into your arms (ready to defend), your in a flight or fight response, the mind attempts to maintain a status quo. In my case, I was often ‘frozen’ (freeze), but took it, dealt with it and tried to channel it into something constructive. It leaves you however drained, angry, saddened, and on ‘alert’ for the next time. The body can only take so much. That ‘alertness’ follows you into sleep…there is no escaping.
25. Pets are therapeutic and know when you are unwell. Welcome their love
26, Remember to care and share ‘you’ with your ‘rainbow’. They come in many shapes and forms.

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